UNASSIGNED: All clinically significant N. glabrata isolates from 2019 to 2021 inclusive were reviewed. AFST was performed locally using the VITEK2 system with the AST-YS08 card, while E-tests were performed at the Mycology Reference Laboratory (MRL), and agreement between these two methods was evaluated - categorical and essential.
UNASSIGNED: Forty-one isolates were reviewed during the study period - 30 from blood cultures, seven from intra-operative theatre specimens and four from sterile site drain fluids. Despite an essential agreement of 100 % within ±2 log2 dilutions, marked discrepancies were noted in interpretative breakpoints between assays with 17 Minor and 16 Major category errors. Categorical agreement was 19.5 %, with the VITEK2 over-estimating resistance. A Mann-Whitney U-test assessed the relationship of MICs across the AFST modalities, and a statistically significant difference was noted, P<0.01, with a higher mean rank for VITKEK2 outputs.
UNASSIGNED: While the VITEK2 system is highly applicable, its performance for CSP AFST is unreliable and potentially results in the mis-classification of susceptible isolates as highlighted in our study. The use of VITEK2 AST-YS08 micafungin as a sentinel echinocandin should be explored and/or the evaluation of CSP-specific E-tests as utilized by the MRL. These methods appear more consistent and less prone to the variation seen with BMD for CSP.
■对2019年至2021年的所有有临床意义的光滑奈瑟菌分离株进行了审查。使用带有AST-YS08卡的VITEK2系统在本地执行AFST,虽然电子测试是在真菌学参考实验室(MRL)进行的,并对这两种方法之间的一致性进行了评估-分类和必要的。
■在研究期间审查了41个分离株-30个来自血液培养物,七个来自术中手术室标本,四个来自无菌部位的引流液。尽管在±2log2稀释度内有100%的基本一致性,在具有17个次要类别错误和16个主要类别错误的测定之间的解释性断点中发现了明显的差异。类别协议为19.5%,与VITEK2过度估计电阻。Mann-WhitneyU检验评估了跨AFST模式的中等收入国家之间的关系,并注意到统计学上的显着差异,P<0.01,VITKEK2输出的平均等级较高。
■虽然VITEK2系统非常适用,其在CSPAFST中的表现不可靠,并可能导致我们研究中强调的易感分离株的分类错误.应探索使用VITEK2AST-YS08米卡芬净作为前哨棘白菌素和/或评估MRL使用的CSP特异性E测试。对于CSP,这些方法看起来更一致且较不容易出现BMD的变化。